Access port including rotatable seals

ABSTRACT

A surgical access device includes a housing; an access member extending distally from the housing and being dimensioned for positioning within tissue, and defining a longitudinal axis; and a seal assembly disposed within the housing. The seal assembly includes first and second seal components respectively having first and second seal members. Each of the first and second seal members defines a passage for passage of a surgical object in substantial sealed relation therewith. The first and second seal components are capable of relative rotation about the longitudinal axis between a first position, in which passages of the first and second seal members are in substantial alignment, and a second position where the passages of the first and second seal members are offset to inhibit the communication of fluid through the seal assembly.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a Continuation application of U.S. patentapplication Ser. No. 12/706,029, filed on Feb. 16, 2010, which claimsthe benefit of, and priority to, U.S. Provisional Patent ApplicationSer. No. 61/162,358, filed on Mar. 23, 2009, now expired, the entirecontents of each being incorporated by reference herein.

BACKGROUND

1. Technical Field

The present disclosure relates to a surgical access device that isremovably insertable into a patient's tissue. More specifically, thepresent disclosure relates to a surgical access device including a sealassembly adapted to accommodate the insertion of surgicalinstrumentation and/or surgical filaments, while substantially limitingthe communication of fluids therethrough.

2. Background of the Related Art

Many surgical procedures are performed through access devices, e.g.,trocar and cannula assemblies. These devices incorporate narrow tubes orcannula percutaneously inserted into a patient's body, through which oneor more surgical objects may be introduced to access a surgicalworksite. Generally, such procedures are referred to as “endoscopic,”unless the procedure is related to the examination/treatment of a joint,in which case the procedure is referred to as “arthroscopic”, or to theexamination/treatment of a patient's abdomen, in which case theprocedure is referred to as “laparoscopic.”

During these procedures, surgical filaments are often used to repairopenings in skin, internal organs, blood vessels, and the like, as inthe case of meniscal repair, and to join various tissues together, as inthe reattachment of ligaments or tendons to bone. Additionally, a fluid,such as saline or an insufflation gas, e.g., carbon dioxide, is oftenintroduced into the surgical worksite to increase visibility or accessto tissue that is the subject of the procedure. Accordingly, theestablishment and maintenance of a substantially fluid-tight seal isdesirably to curtail the escape of such fluids and thereby preserve theintegrity of the surgical worksite. To this end, surgical access devicesgenerally incorporate a seal through which the surgical object and/orsurgical filaments are inserted.

While many varieties of seals are known in the art, there exists acontinuing need for a seal that can accommodate a variety ofdifferently-sized surgical objects and/or surgical filaments whilesubstantially limiting the escape of fluids.

SUMMARY

Accordingly, the present disclosure is directed to a surgical accessdevice for use during a surgical procedure. The surgical access deviceincludes a housing, an access member extending distally from the housingand being dimensioned for positioning within tissue, and defining alongitudinal axis; and a seal assembly disposed within the housing. Theseal assembly includes first and second seal components respectivelyhaving first and second seal members. Each of the first and second sealmembers defines a passage for passage of a surgical object insubstantial sealed relation therewith. The first and second sealcomponents are capable of relative rotation about the longitudinal axisbetween a first position, in which passages of the first and second sealmembers are in substantial alignment, and a second position where thepassages of the first and second seal members are out of alignment toinhibit the communication of fluid through the seal assembly. At leastone of the first and second seal components may be at least partiallyreceivable within the other of the first and second seal components. Theseal members may be configured as multi-slit valves. The first sealcomponent may include a first base member and a first cap extendingproximally therefrom, and the second seal component may include a secondbase member and a second cap extending proximally therefrom. The firstcap may define a transverse dimension that is smaller than a transversedimension of the first base member, and the second cap defines atransverse dimension that is smaller than a transverse dimension of thesecond base member. The first base member may define an internal cavityconfigured and dimensioned to receive the second cap.

Detent means for releasably securing the first and second sealcomponents in either of the first and second positions may be provided.The first seal component may include at least one detent configured anddimensioned for positioning within at least one recess on the secondseal component. The seal assembly may include at least one bearing tofacilitate relative rotation between the first and second sealcomponents.

A method of performing a surgical procedure, includes the steps of:

accessing a body cavity with a surgical access device, the access deviceincluding first and second seal components respectively having first andsecond seal members, each of the first and second seal members defininga passage for passage of a surgical object;

positioning the first seal component and the second seal component at afirst relative angular position whereby passages of the first and thesecond seal components are offset from each other to substantiallyprevent the passage of fluid;

moving, e.g., by rotating, the first seal component and the second sealcomponent to a second relative angular position whereby passages of thefirst and the second seal components are in general alignment;

subsequent to the step of moving, introducing a surgical objects intothe surgical worksite through the surgical access device to carry outthe surgical procedure.

In another aspect of the present disclosure, a seal assembly adapted foruse with a surgical access device is disclosed. The seal assemblyincludes first and second seal components respectively having first andsecond seal members. The first and second seal components are capable ofrelative rotation such that the seal assembly is movable from a firstposition, in which passages defined by the first and second seal membersare in substantial alignment, to a second position, in which thepassages defined by the first and second seal members are out ofalignment to inhibit communication of fluid through the seal assembly.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the present disclosure are described herein belowwith references to the drawings, wherein:

FIG. 1 is a side, schematic view of a surgical access device includingone embodiment of a seal assembly that includes first and second sealcomponents in accordance with the principles of the present disclosure;

FIG. 2 is a side, perspective view of the seal assembly seen in FIG. 1illustrating the first and second seal components separated from eachother and shown in a first condition in which passages of the sealmembers included on the first and second seal components are insubstantial alignment;

FIG. 3 is a side, schematic view of the seal assembly seen in FIG. 1illustrating the first seal component separated from the second sealcomponent;

FIG. 4 is a side, perspective view of an alternate embodiment of theseal assembly seen in FIG. 1 including seal members configured assingle-slit valves;

FIG. 5 is a side, perspective view of the seal assembly seen in FIGS.1-2 illustrating the first and second seal components separated fromeach other and shown in a second condition in which the passages of theseal members are offset from one another;

FIG. 6 is a side, perspective view of another embodiment of the sealassembly seen in FIG. 1 including a plurality of bearings to facilitaterepositioning of the seal assembly between the first and secondpositions;

FIG. 7 is a flow chart describing a method of using the surgical accessdevice of FIG. 1 during the course of an arthroscopic surgicalprocedure;

FIG. 8 is a side, schematic view of another embodiment of the sealassembly seen in FIG. 1 including first and second seal components thatare substantially identical in structure shown separated from eachother; and

FIG. 9 illustrates another embodiment of the seal assembly seen in FIG.1 including a first seal component with a plurality of recesses and asecond seal component including a plurality of detents.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

In the drawings and in the description which follows, in which likereferences numerals identify similar or identical elements, the term“proximal” should be understood to refer to the end of the disclosedsurgical access device, or any component thereof that is closest to apractitioner during use, while the term “distal” should be understood asreferring to the end that is farthest from the practitioner during use.Additionally, the term “surgical object” should be understood to includeany surgical object or instrument that may be employed during the courseof surgical procedure, including but not being limited to an obturator,a surgical stapling device, or the like; the term “filament” should beunderstood to refer to any elongate member suitable for the intendedpurpose of joining tissue, including but not limited to sutures,ligatures, and surgical tape; and the term “tissue” should be understoodto refer to any bodily tissue, including but not limited to skin,fascia, ligaments, tendons, muscle, and bone.

FIG. 1 illustrates a surgical access device 1000 including a housing1002 at a proximal end 1004 thereof and an access member 1006 extendingdistally therefrom. The housing 1002 is configured and dimensioned toaccommodate a seal assembly, one embodiment of which is shown andreferred to generally by reference character 100, and may be anystructure suitable for this intended purpose.

The access member 1006 is dimensioned for positioning with apercutaneous access point “P” formed in a patient's tissue “T”, e.g., apatient's knee. The access member 1006 defines a passageway 1008extending longitudinally therethrough along a longitudinal axis “A.” Thepassageway 1008 is configured and dimensioned for the internal receiptof one or more surgical filaments “F” and/or a surgical object, orobjects “I.” The access member 1006 defines an opening 1010 at a distalend 1012 thereof to allow the surgical filaments “F” and the surgicalobject “I” to pass therethrough.

Referring now to FIGS. 2-5 as well, the seal assembly 100 will bediscussed. The seal assembly 100 includes at least two seal components102 a, 102 b. The seal components 102 a, 102 b may be formed of anysuitable biocompatible and at least semi-resilient material, and may beformed through any suitable method of manufacture, including but notlimited to molding, casting, and electrical discharge machining (EDM).Examples of suitable materials include, but are not limited toelastomeric materials such as natural rubber, synthetic polyisoprene,butyl rubber, halogenated butyl rubbers, polybutadiene,styrene-butadiene rubber, nitrile rubber, hydrogenated nitrile rubbers,chloroprene rubber, ethylene propylene rubber, ethylene propylene dienerubber, epichlorohydrin rubber, polyacrylic rubber, silicone rubber,fluorosilicone rubber, fluoroelastomers, perfluoroelastomers, polyetherblock amides, chlorosulfonated polyethylene, ethylene-vinyl acetate,thermoplastic elastomers, thermoplastic vulcanizers, thermoplasticpolyurethane, thermoplastic olefins, resilin, elastin, and polysulfiderubber. Forming the seal components 102 a, 102 b from such materialspermits the seal components 102 a, 102 b to resiliently accommodate theinsertion, manipulation, and removal of the surgical filaments “F”, aswell as surgical objects “I” that may vary in size.

The seal components 102 a, 102 b of the illustrated embodimentsrespectively include base members 104 a, 104 b and caps 106 a, 106 b. Inone embodiment of the seal assembly 100, as seen in FIG. 1-3 forexample, the base member 104 a of the seal component 102 a includes aninternal cavity 108 that defines an internal transverse dimension “D1.”The caps 106 a, 106 b extend proximally from the base members 104 a, 104b, respectively, and may be either substantially solid members, asillustrated, or hollow structures that define internal spaces. The caps106 a, 106 b each define an outer transverse dimension “D2” thatsubstantially approximates the internal transverse dimension “D1” of thecavity 108 such that the seal assembly 100 can be assembled as seen inFIG. 1, i.e., such that the cap 106 b of the seal component 102 b isreceived by the internal cavity 108 defined within the base member 104 aof the seal component 102 a. While illustrated as substantially circularin configuration, the base members 104 a, 104 b and the caps 106 a, 106b may exhibit any suitable geometrical configuration in alternateembodiments of the seal assembly 100.

The proximal surfaces 110 a, 110 b of the caps 106 a, 106 b respectivelyinclude seal members 112 a, 112 b having respective passages 114 a, 114b. Although depicted as multi-slit valves 115 a, 115 b in the embodimentof the seal assembly 100 seen in FIGS. 2 and 5, for example, the sealmembers 112 a, 112 b may include any passage suitable for the intendedpurpose of substantially limiting the communication of fluids, e.g.,saline or insufflation gas, through the seal assembly 100, including butnot limited to single slit-valves 116 a, 116 b, as seen in FIG. 4. Thepassages 114 a, 114 b of the seal members 112 a, 112 b extend throughthe seal components 102 a, 102 b (FIGS. 2-3), and are normally biasedtowards a closed condition, as seen in FIG. 2 for example, to provide asubstantially fluid-tight seal in the absence of surgical filaments “F”and/or the surgical object “I”. The seal members 112, 112 b are alsoconfigured to help minimize the escape of fluid through the sealassembly 100 when the surgical filaments “F” and/or the surgical object“I” is inserted therethrough.

The seal components 102 a, 102 b are relatively rotatable from a firstposition, seen in FIG. 2, in which the respective passages 114 a, 114 bof the seal members 112 a, 112 b in substantial alignment, into a secondposition, seen in FIG. 5, in which the respective passages 114 a, 114 bof the seal members 112 a, 112 b are offset from one another. Rotatingthe seal components 102 a, 102 b interrupts and substantially closes offthe path of any fluid communicated proximally through the surgicalaccess device 1000 (FIG. 1) to further help ensure against anysubstantial leakage of fluid.

In one embodiment, as seen in FIGS. 1-5, the seal assembly 100 includesa tactile member 118 to facilitate repositioning of a portion of theseal assembly 100 between the first and second positions. The tactilemember 118 can be coupled to either the seal component 102 a, as seen inFIGS. 1-5, or seal component 102 b, and depends outwardly therefromthrough an opening 1014 (FIG. 1) in the housing 1002 of the surgicalaccess device 1000 such that the practitioner can manually manipulatethe relative position of the seal component 102 a, 102 b. In alternateembodiments of the seal assembly 100, relative movement between the sealcomponent 102 a, 102 b may be effectuated in any suitable manner,including but not limited to the incorporation of a mechanized assembly,such as a motor and gear set. As seen in FIG. 6, in one embodiment ofthe seal assembly, referred to generally by reference character 200,either or both of the seal components 202 a, 202 b may include bearings218, or any other suitable structure, to assist in the relative movementof the seal components 202 a, 202 b between the first and secondpositions.

With reference now to FIGS. 1-7, the use and function of the surgicalaccess device 1000 during the course of an arthroscopic procedure willbe discussed. Initially, a fluid, such as saline, is introduced into thesurgical worksite. Thereafter, the access member 1006 is positionedwithin the percutaneous access point “P” formed in the patient's tissue“T”, and the surgical object “I” and/or the surgical filament “F” areintroduced into the surgical worksite by passage through the housing1002 and the access member 1006. Either prior to the insertion of thesurgical object “I” and/or the surgical filament “F” or at any otherpoint during the course of the procedure, the practitioner may move theseal assembly 100 from the first position to the second position toregulate the leakage of any fluid. Subsequently, the practitioner canmanipulate the surgical object “I” and/or the surgical filament “F”through the surgical access device 1000 to carry out the remainder ofthe procedure.

FIGS. 8-9 illustrate alternate embodiments of the seal assembly,referred to generally by reference numbers 300 and 400. The sealassembly 300 includes seal components 302 a, 302 b that aresubstantially identical in structure. Specifically, the seal components302 a, 302 b include base members 304 a, 304 b that each defines acavity 308. Including two seal components 302 a, 302 b that aresubstantially identical in structure allows for a substantial reductionin manufacturing costs, e.g., tooling costs, in that the total number ofparts requiring fabrication is reduced by one.

The seal assembly 400 seen in FIG. 9 includes base members 404 a, 404 bincorporating corresponding structure that is configured to selectivelymaintain the first and second positions of the seal components 402 a,402 b described above and respectively seen in FIGS. 2 and 5. In theembodiment of the seal assembly 400 seen in FIG. 9, the base member 404b includes a pair of detents 420 formed on a proximal surface 422thereof that are configured and dimensioned to engage either a firstpair of recess 424 or a second pair of recesses 426 formed on a distalsurface 428 of the base member 404 a. The detents 420 engage the firstpair of recesses 424 when the seal assembly 400 is in the firstposition, i.e., when the respective passages 414 a, 414 b of the sealmembers 412 a, 412 b are in substantial alignment, and the second pairof recesses 426 when the seal assembly 400 is in the second position,i.e., when the respective passages 414 a, 414 b of the seal members 412a, 412 b are offset from each other. The detents 422 and the respectivefirst and second pairs of recesses 424, 426 are configured anddimensioned such that the first and second positions are maintaineduntil a predetermined force has been applied to seal assembly 400, e.g.,through use of the tactile member 418.

Although the illustrative embodiments of the present disclosure havebeen described herein with reference to the accompanying drawings, theabove description, disclosure, and figures should not be construed aslimiting, but merely as exemplifications of particular embodiments. Itis to be understood, therefore, that the disclosure is not limited tothose precise embodiments, and that various other changes andmodifications may be effected therein by one skilled in the art withoutdeparting from the scope or spirit of the disclosure. For example,although each embodiment of the seal assembly is illustrated asincluding two seal components, embodiments including three or more sealcomponents arranged in accordance with the manner described above arealso within the scope of the present disclosure. Additionally, personsskilled in the art will appreciate that the features illustrated ordescribed in connection with one embodiment may be combined with thoseof another, and that such modifications and variations are also intendedto be included within the scope of the present disclosure.

1. A method of performing a surgical procedure, comprising the steps of:accessing a body cavity with a surgical access device including firstand second seal components; positioning the first seal component and thesecond seal component at a first relative angular position, wherebypassages extending through the first and second seal components areoffset from each other to substantially inhibit fluid communicationthrough the surgical access device; moving the first seal component andthe second seal component to a second relative angular position, wherebythe passages extending through the first and second seal components arein general alignment; and thereafter, introducing a surgical object intoan internal surgical worksite through the surgical access device tocarry out the surgical procedure.
 2. The method of claim 1, wherein thestep of moving the first seal component and the second seal componentincludes effectuating relative rotation between the first and secondseal components.
 3. The method of claim 1 further including the step ofintroducing a fluid into the body cavity to insufflate the body cavity.4. A seal assembly adapted for use with a surgical access device, theseal assembly comprising: first and second seal components respectivelyincluding first and second seal members, wherein the first and secondseal components are configured and dimensioned for relative rotationsuch that the seal assembly is movable between a first position, inwhich passages extending through the first and second seal members arein general alignment, and a second position, in which the passagesextending through the first and second seal members are offset, toinhibit communication of fluid through the seal assembly.
 5. The sealassembly of claim 4, wherein the first and second seal components areidentical in structure.
 6. The seal assembly of claim 4, wherein theseal members are configured as multi-slit valves.
 7. The seal assemblyof claim 4, wherein at least one of the first and second seal componentsis at least partially receivable within the other of the first andsecond seal components.
 8. The seal assembly of claim 7, wherein thefirst seal component includes a first base member and a first capextending proximally therefrom, and the second seal component includes asecond base member and a second cap extending proximally therefrom. 9.The seal assembly of claim 8, wherein the first cap defines a transversedimension that is smaller than a transverse dimension of the first basemember, and the second cap defines a transverse dimension that issmaller than a transverse dimension of the second base member.
 10. Theseal assembly of claim 9, wherein the first base member defines aninternal cavity configured and dimensioned to receive the second cap.11. The seal assembly of claim 4, further including detent meansconfigured and dimensioned to releasably secure the first and secondseal components together in either of the first and second positions.12. The seal assembly of claim 11, wherein the first seal componentincludes at least one detent configured and dimensioned for positioningwithin at least one corresponding recess formed in the second sealcomponent.
 13. The seal assembly of claim 4, wherein the seal assemblyincludes at least one bearing to facilitate relative rotation betweenthe first and second seal components.
 14. A surgical access device,which comprising: a housing; and a seal assembly disposed within thehousing, the seal assembly including first and second seal components inoperative connection such that the first and second seal components arecapable of relative rotation within the housing about the longitudinalaxis to control fluid communication through the seal assembly.
 15. Thesurgical access device of claim 14, wherein the first seal componentincludes a first seal member, and the second seal component includes asecond seal member, each of the first and second seal members includinga passage extending therethrough configured and dimensioned to removablyreceive a surgical object in substantial sealed relation therewith. 16.The surgical access device of claim 15, wherein the first and secondseal components are capable of relative rotation between a firstposition, in which the passages of the first and second seal members arein general alignment, and a second position, in which the passages ofthe first and second seal members are out of alignment, to inhibit fluidcommunication through the seal assembly.
 17. The surgical access deviceof claim 14, wherein the first and second seal components are identicalin structure.
 18. The seal assembly of claim 14, wherein at least one ofthe first and second seal components is at least partially receivablewithin the other of the first and second seal components.
 19. The sealassembly of claim 18, wherein the first seal component includes a firstbase member and a first cap extending proximally therefrom, and thesecond seal component includes a second base member and a second capextending proximally therefrom.
 20. The seal assembly of claim 19,wherein the first base member defines an internal cavity configured anddimensioned to receive the second cap.